Making if-then plans counteracts learned non-use in stroke patients: A proof-of-principle study

Marquardt, Michael K.; Cohen, Anna Lisa; Gollwitzer, Peter M.; Gilbert, Sam J.; Dettmers, Christian

doi:10.3233/rnn-170748

Cited by 53 publications

(4 citation statements)

References 29 publications

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“…17,18 Although the term "learned nonuse" itself has not appeared in the MS literature, this condition likely commonly follows chronic motor disability in this disease. In contrast, the term is widely used in both the stroke clinical [31][32][33] as well as the experimental neuroscientific literature. [34][35][36] Multiple reports describe persons with MS who have chronically self-restricted limb use and concurrent behavioral compensation, who nonetheless can move substantially more when urged, [37][38][39][40] thus suggesting learned nonuse.…”

Section: Discussionmentioning

confidence: 99%

Phase II Randomized Controlled Trial of Constraint-Induced Movement Therapy in Multiple Sclerosis. Part 1: Effects on Real-World Function

Mark

Taub

Uswatte

et al. 2018

Neurorehabil Neural Repair

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Background. Constraint-Induced Movement therapy (CIMT) has controlled evidence of efficacy for improving real-world paretic limb use in non-progressive physically disabling disorders (stroke, cerebral palsy). Objective. This study sought to determine whether this therapy can produce comparable results with a progressive disorder such as multiple sclerosis (MS). We conducted a preliminary phase II randomized controlled trial of CIMT versus a program of complementary and alternative medicine (CAM) treatments for persons with MS, to evaluate their effect on real-world disability. Methods. Twenty adults with hemiparetic MS underwent 35 hours of either CIMT or CAM over 10 consecutive weekdays. The primary clinical outcome was change from pretreatment on the Motor Activity Log (MAL). Results. The CIMT group improved more on the MAL (2.7 points, 95% confidence interval 2.2-3.2) than did the CAM group (0.5 points, 95% confidence interval −0.1 to 1.1; P < .001). These results did not change at 1-year follow-up, indicating long-term retention of functional benefit for CIMT. The treatments were well tolerated and without adverse events. Conclusion. These results suggest that CIMT can increase real-world use of the more-affected arm in patients with MS for at least 1 year. Clinical Trial Registration. ClinicalTrials.gov NCT01081275.

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Section: Discussionmentioning

confidence: 99%

Phase II Randomized Controlled Trial of Constraint-Induced Movement Therapy in Multiple Sclerosis. Part 1: Effects on Real-World Function

Mark

Taub

Uswatte

et al. 2018

Neurorehabil Neural Repair

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“…For instance, Cohen, Bayer, Jaudas, and Gollwitzer (2008, Study 2; see also Miles & Proctor, 2008) observed the suppression of habitual responses using a Simon task paradigm; the Simon task allows to compare the control of habitual responses (e.g., grabbing things presented on the right side of the person with the right arm) as compared to nonhabitual responses (e.g., grabbing things presented on the right side with the left arm). Expanding this research to a clinical sample, Marquardt, Cohen, Gollwitzer, Gilbert, and Dettmers (2017) had stroke patients with a mild to moderate hand paresis perform the Simon task before and after they had formed respective if-then plans. A significant Simon effect (i.e., comparatively faster responding in corresponding trials where things need to be responded to with the arm of the side where the stimulus is presented as compared to noncorresponding trials) was observed in both the affected and the nonaffected arm; however, there was no longer a significant Simon effect for trials that were prepared by forming if-then plans.…”

Section: Goal Intentions Versus Implementation Intentionsmentioning

confidence: 99%

The goal concept: A helpful tool for theory development and testing in motivation science.

Gollwitzer¹

2018

Motivation Science

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In the present article, I will try to elucidate how relying on the goal concept facilitates the development and testing of theories in the science of motivation. For this purpose, I will focus on those theories whose development I was closely involved with: the selfcompletion theory , the mindset theory of action phases Gollwitzer, 1990), and the theory of if-then planning (Gollwitzer, 1999(Gollwitzer, , 2014. So the focus is not on discussing the many different goal theories that have been developed and tested in the psychology of motivation by addressing the consequences of setting, striving for, and attaining goals of a different kind, or the various self-regulation strategies that have been suggested to help people commit to, pursue, and attain these goals. Rather, I'll try to demonstrate convincingly that the goal concept is a powerful tool when it comes to creating theories that facilitate the understanding of phenomena that are at the center stage in the science of motivation.

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“…In order to adapt to the motor disability that these symptoms generate, patients develop compensatory behaviors characterized by a decrease in the use of their affected arm and an increased use of the opposite arm, despite, in many cases, the functional recovery of their affected arm [ 10 , 17 , 18 ]. This behavior of the non-use of the affected arm, even in the presence of functional capacity, corresponds to the “learned non-use” phenomenon, described as the learned non-use between the impairment and the functional capacity or actual use of the upper limb [ 10 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Reliability and Validity of the Motor Activity Log (MAL-30) Scale for Post-Stroke Patients in a Spanish Sample

Santamaría-Peláez

Pardo-Hernández

González-Bernal

et al. 2022

IJERPH

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Background: The validation of assessment instruments is of great importance when they are applied in clinical and healthcare settings, since their safe and reliable use is essential for the application of appropriate and high-quality treatments. The motor activity log (MAL-30) is an instrument widely used by professionals in the clinic, which has been validated in different countries, languages and populations. The aim of this study was to determine the reliability and validity of the MAL-30 scale for post-stroke patients in a Spanish sample. Methods: For this purpose, internal consistency tests were carried out using Cronbach’s alpha, item–item and item–total correlations, and a half-and-half test for reliability. For the validation, criterion validity tests were performed using the Fugl-Meyer assessment scale as the gold standard, and the convergent validity tests were carried out by correlation with the action research arm test (ARAT), box and block test (BBT), functional independence measure (FIM)–functional assessment measure (FAM), Lawton and Brody index and stroke quality of life scale (ECVI-38). Results: The results showed good internal consistency, as well as a good criterion and convergent validity. Conclusions: The MAL-30 instrument can be considered a valid and reliable tool for assessing the quantity and quality of the use of the affected upper limb in the performance of the activities of daily living and the instrumental activities of daily living after stroke in a Spanish sample.

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Making if-then plans counteracts learned non-use in stroke patients: A proof-of-principle study

Abstract: This observation opens a potential new route to improving stroke rehabilitation. If-then plans may qualify as a viable strategy to overcome the learned non-use of the affected arm. Further research is now required to develop and test therapeutic measures based on this proof-of-principle.

Cited by 53 publications

References 29 publications

Phase II Randomized Controlled Trial of Constraint-Induced Movement Therapy in Multiple Sclerosis. Part 1: Effects on Real-World Function

Phase II Randomized Controlled Trial of Constraint-Induced Movement Therapy in Multiple Sclerosis. Part 1: Effects on Real-World Function

The goal concept: A helpful tool for theory development and testing in motivation science.

Reliability and Validity of the Motor Activity Log (MAL-30) Scale for Post-Stroke Patients in a Spanish Sample

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